HIT Standards CommitteeHIT Standards Committeee-Prescribing of Discharge e-Prescribing of Discharge Medications Power TeamMedications Power Team

Jamie Ferguson, Chair

September 28, 2011

Power Team Members

• Jamie Ferguson, Chair• Don Bechtel, Siemens• Ken Gebhart, NIST• Kevin Hutchinson, Prematics• Liz Johnson, Tenet• Scott Robertson, KP• David Yakimischak, Surescripts

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On July 20 the HITSC endorsed the Power Team recommendations with two amendments: Identify specific HL7 version numbers for HL7 discharge

prescription messaging to be used in EHR certification (Action item) Omit data element list for RxNorm (No further action required)

The Power Team met with NIST repeatedly regarding HL7 prescription messaging in EHR certification in order to: Identify the specific HL7 messages for discharge eRx that can

implement the Medicare Part D regulation text Ensure workability/practicality of certification testing for these Ensure comparability of eRx messaging for discharge

medications with NCPDP SCRIPT vs. HL7 prescriptions3

Power Team Status Recap

HL7 Versions

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Any valid HL7 version 2 prescription message (version 2.2 through 2.5.1) meets requirements of Medicare Part D

Defined requirements for “valid HL7 version 2 prescription message” – NIST MU Mandatory Criteria mapped to HL7 version 2.2 through version 2.5.1: Product Identification RXO.1 Prescription Quantity RXO.11 + RXO.12 Sig (text) RXO.7.2 Date written ORC.9 Refills RXO.13

Certification Comparability

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Mandatory test elements, NCPDP mapped to HL7 v2.xSCRIPT EDIFACT SCRIPT XML HL7 v2.x (V2.2 – V2.5.1)

ØØØ SØ19 Ø1 ØØ13 Segment code /MedicationPrescribed not applicable to HL7 Ø1Ø IØ13 Ø1 7ØØ9 Item Description Identification

No equivalent in XML not applicable to HL7

Ø1Ø IØ13 Ø2 7ØØ8 Item Description /MedicationPrescribed/DrugDescription RXO-1.2 Requested Give Code.Text

Ø1Ø IØ13 Ø8 1154 Reference Number /MedicationPrescribed/DrugDBCode RXO-1.1 Requested Give Code.Identifier

Ø1Ø IØ13 Ø9 1153 Reference Qualifier /MedicationPrescribed/DrugDBCodeQualifier RXO-1.3 Requested Give Code.Name of Coding System

Ø2Ø IØØ9 Ø1 6Ø63 Quantity Qualifier /MedicationPrescribed/Quantity/Qualifier RXO-12.1 Requested Dispense Units.Identifier

Ø2Ø IØØ9 Ø2 6Ø6Ø Quantity /MedicationPrescribed/Quantity RXO-11 Requested Dispense Amount

Ø2Ø IØØ9 Ø3 1131 Code List Qualifier /MedicationPrescribed/Quantity/CodeListQualifier not applicable to HL7

Ø3Ø IØ14 Ø2 Dosage /MedicationPrescribed/Directions RXO-7.2 Provider's Administration Instructions.Text

Ø4Ø IØØ6 Ø1 2ØØ5 Date/Time Period Qualifier

No equivalent in XML not applicable to HL7

Ø4Ø IØØ6 Ø2 238Ø Date/Time/Period /MedicationPrescribed/WrittenDate ORC-9 Date Time of Transaction

Ø6Ø IØØ9 Ø1 6Ø63 Quantity Qualifier /MedicationPrescribed/Refills/Qualifier not applicable to HL7

Ø6Ø IØØ9 Ø2 6Ø6Ø Quantity /MedicationPrescribed/Refills/Quantity RXO-13 Number of Refills

Summary & Recommendation

HL7 Amendment to Power Team recommendation: eRx for discharge medications may use HL7 version 2.2 through version 2.5.1 prescription messages, as described above Aligns EHR certification with Medicare Part D regulations Practical and testable Alternative standards allowed in Part D are comparable

Request HITSC approval of HL7 amendment to previous recommendations of standards for eRx of discharge medications

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